28
Volume 04 Issue 04-2022
The American Journal of Medical Sciences and Pharmaceutical Research
(ISSN
–
2689-1026)
VOLUME
04
I
SSUE
04
Pages:
28-31
SJIF
I
MPACT
FACTOR
(2020:
5.
286
)
(2021:
5.
64
)
(2022:
6.
319
)
OCLC
–
1121105510
METADATA
IF
–
7.569
Publisher:
The USA Journals
ABSTRACT
In most cases, the cause of dementia in the elderly is Alzheimer's disease (AD). The aim of the study is to study patients
at an early stage of Alzheimer's type dementia at the outpatient level using the methods of the general cognitive
decline - Reisberg scale, the short mental status assessment scale - MMSE test, the dementia stages scale – CDR. It is
expected that about 30 patients with clinical and neurological diseases will be examined in the outpatient department.
People with AD may experience various problems, ranging from remembering many recent events to the names of
people they know. The problem of early diagnosis of dementia such as Alzheimer's disease has extreme medical and
social significance due to the significant frequency and high percentage of their development.
KEYWORDS
Alzheimer's disease; Alzheimer's type dementia; CHEM, vascular dementia, MMSE test
Research Article
OPTIMIZATION OF APPROACHES TO EARLY DIAGNOSIS OF
ALZHEIMER'S TYPE DEMENTIA AT THE OUTPATIENT LEVEL
Submission Date:
April 05, 2022,
Accepted Date:
April 15, 2022,
Published Date:
April 28, 2022 |
Crossref doi:
https://doi.org/10.37547/TAJMSPR/Volume04Issue04-08
Dilshod Sirojovich Tolibov
Doctor Of Science Of The Department Of Neurology And Medical Psychology, Tashkent Medical Academy,
Uzbekistan
Rushana Abubakirovna Salimova
Master Of The Department Of Neurology And Medical Psychology, Tashkent Medical Academy, Uzbekistan
Jamoliddin Muxiddin-O’g’li Sharafiddinov
Master Of The Department Of Neurology And Medical Psychology, Tashkent Medical Academy, Uzbekistan
Journal
Website:
https://theamericanjou
rnals.com/index.php/ta
jmspr
Copyright:
Original
content from this work
may be used under the
terms of the creative
commons
attributes
4.0 licence.
29
Volume 04 Issue 04-2022
The American Journal of Medical Sciences and Pharmaceutical Research
(ISSN
–
2689-1026)
VOLUME
04
I
SSUE
04
Pages:
28-31
SJIF
I
MPACT
FACTOR
(2020:
5.
286
)
(2021:
5.
64
)
(2022:
6.
319
)
OCLC
–
1121105510
METADATA
IF
–
7.569
Publisher:
The USA Journals
INTRODUCTION
According to leading experts and from the official
point of view of expert groups of such prestigious
institutions as WHO and the National Institute of Aging
of the USA, it is currently considered one of the most
common diseases in the elderly and senile. AD is
currently comparable in prevalence with myocardial
and brain infarctions among the elderly population.[1]
In recent years, the problem of cognitive impairment in
Alzheimer's dementia has not only become extremely
relevant, but has also acquired interdisciplinary
features, due to their high prevalence among the
elderly and social significance.
Currently, the problem of vascular lesions of the brain
is becoming increasingly relevant due to the increasing
prevalence of cerebrovascular pathology, including
among young and middle-aged people. [2] Among the
neurological symptoms that develop as a result of
vascular lesions of the brain, a special place is occupied
by cognitive disorders that have a pronounced
negative impact on the quality of life of patients.[3]
According to WHO, there are currently about 47 million
people with dementia worldwide, and it is expected
that in ten years this number will reach about 75-80
million.[4]
Dementia is one of the main causes of disability in the
elderly. The first place among the causes of dementia
is occupied by AD, but in practice the most common is
a mixed form (Alzheimer's disease in combination with
cerebrovascular disease).[5] The disease can have
serious consequences not only for the victims, but also
for their families and those who care for them. There is
often a lack of awareness and understanding of
dementia, which leads to stigmatization and barriers to
diagnosis and treatment. The impact of dementia on
caregivers, families and society as a whole can be
physical, psychological, social, as well as economic.[6]
The problem of timely detection of Alzheimer's type
dementia at the outpatient level has not yet been fully
studied.[7]
OBJECTIVE
To study patients at the early stage of the
manifestation of vascular dementia and Alzheimer's
type dementia at the outpatient level of the Tashkent
Medical Academy using a scale of general cognitive
decline -Rizberg, a short scale for assessing mental
status - MMSE test, a scale of stages of dementia
development - CDR records.
MATERIALS AND METHODS OF RESEARCH
About 30 patients were examined on the basis of the
Tashkent Medical Academy, in the departments of
neurology, as well as in the polyclinic of this TMA. 1.
Clinical, neurological and control study of patients with
chronic cerebral ischemia of stage I and II without
cognitive impairment (10 people) and with chronic
cerebral ischemia with vascular dementia. (10 people).
2. Patients with Alzheimer's type dementia (10 people)
were examined. Several methods were carried out to
determine clinical and neurological disorders. The
examination methods used such tests as the scale of
general cognitive decline -Raisberg; a short scale for
assessing mental status – the MMSE test, the scale of
stages of dementia development - CDR. (Diagram – 1)
RESULTS
According to the scale method, the overall decrease in
cognitive functions in the 1st group of patients with
CHEM and vascular dementia was assessed on an
average of 20 patients (4.1±0.22) on a point scale.
During the examination, patients had a cognitive
30
Volume 04 Issue 04-2022
The American Journal of Medical Sciences and Pharmaceutical Research
(ISSN
–
2689-1026)
VOLUME
04
I
SSUE
04
Pages:
28-31
SJIF
I
MPACT
FACTOR
(2020:
5.
286
)
(2021:
5.
64
)
(2022:
6.
319
)
OCLC
–
1121105510
METADATA
IF
–
7.569
Publisher:
The USA Journals
deficit, which is clearly revealed during a clinical
examination, difficulty traveling and financial affairs,
forget events from their personal life, which has been
observed on average for the last 2 years. In the 2nd
group with Alzheimer's type dementia, all 10 patients
had a decrease in cognitive functions of the brain,
estimated from (5.2 ± 0.20) points. Patients have an
inability to fully live independently, need some help,
forget some of their personal data such as: address,
names of graduated educational institutions, etc. they
need control when performing everyday actions. All
these disorders last an average of 1.5 years.
In the MMSE test in group 1, 20 patients were assessed
on average by (14.15 ± 0.38) points. Patients have
moderate degree of dementia. In the 2nd group of
patients in 10 patients, the result was (9.3±0.47) points,
with severe dementia.
In a study on the CDR scale in group 1, 20 patients were
assessed on average (1,375±0.14) points with mild
dementia. Changes in memory with a slight loss of it,
mainly for events that have occurred recently.
Moderate difficulties with solving problems, cannot
function independently in public affairs, difficulties in
daily activities. In group 2, 10 patients had an average
(2.5±0.11) score with more severe dementia. The
patients were diagnosed with severe memory loss,
disorientation, can not solve any problems themselves
at all, do not participate in public affairs. Need help
with all the tasks of daily life and need help with most
personal hygiene. Urinary incontinence is common.
Diagram – 1
: Chart comparing results test like a Reisberg, MMSE, CDR
1. Chemical I-II art. without cognitive impairment and vascular dementia;
2. CHEM with Alzheimer's type dementia.
0
5
10
15
I-group
II-group
Car
ri
e
d
o
u
t
te
sts
I-group
II-group
Reisberg
4.1
5.2
MMSE
14.15
9.3
CDR
1.375
2.5
Chart for comparing results
31
Volume 04 Issue 04-2022
The American Journal of Medical Sciences and Pharmaceutical Research
(ISSN
–
2689-1026)
VOLUME
04
I
SSUE
04
Pages:
28-31
SJIF
I
MPACT
FACTOR
(2020:
5.
286
)
(2021:
5.
64
)
(2022:
6.
319
)
OCLC
–
1121105510
METADATA
IF
–
7.569
Publisher:
The USA Journals
CONCLUSION
Examination for violations of cognitive functions of the
brain should be carried out in all primary care
institutions in the outpatient clinic for their earlier
detection. With the help of these tests, it is easy to
determine the degree of cognitive impairment of the
brain at an early stage. In addition, AD is the most
common form of dementia among the elderly.
Dementia is a brain disorder that seriously affects a
person's ability to perform everyday activities. Blood
pressure begins to rise slowly. First of all, this applies
to those parts of the brain that control thinking,
memory and language. People with AD may have
trouble remembering what happened recently or the
names of people they know. A related problem, mild
cognitive impairment, causes more memory problems
than usual in people of the same age.
REFERENCES
1.
Balunov O.A., Lukina L.V. Differential diagnosis of
dementia and affective disorders in the elderly in
the outpatient practice of a neurologist. – St.
Petersburg, 2012. – 36 p.
2.
Gavrilova S.I. Alzheimer's disease. Modern ideas
about diagnosis and therapy. - M., 2012. -80 s
3.
Levin O.S., Vasenina E.E. Diagnosis and treatment
of cognitive disorders and dementia. – M.:
Medpress-inform, 2015. - 80 p.
4.
Shadrina I.V., Mamin G.V., Pugachev A.N.
Dementia in Alzheimer's disease - Chelyabinsk,
2013. - 40 p.
5.
Andrew S.P., Yu L.L., Kovger M., Schneider J.A.
and others. Sleep changes the association of
APOE with the risk of developing Alzheimer's
disease.-2013.
6.
Moran M.A., Mason E.J., Gomez-Ramos P./
Cholinesterases with localization of foci of
neurofibrillary degeneration in the senile brain
and in Alzheimer's disease. // Actaneuropatol.
Berl. -1994. - Vol. 87. - N. 3. - pp. 284-292.
7.
Raskin S.M. et al. Accuracy in predicting MCI
subtypes for Alzheimer's disease and vascular
dementia in patients with moderate cognitive
impairment: A 2-year follow-up study, Dement.
Great. Cohn. Discord. - 2005.